NFPA-25 INSPECTION, TESTING AND …€¦ · nfpa-25 inspection, testing and maintenance of wet pipe fire sprinkler system ... nfpa 1962? yes nicno n/a

NFPA-25 INSPECTION, TESTING AND MAINTENANCE OF WET PIPE FIRE SPRINKLER SYSTEM Information on this form covers the minimum requirements of NFPA 25-2011 for fire sprinkler systems connected to distribution systems not including

supplemental tanks or fire pumps. Separate forms are available to inspect, test, and maintain the remainder of the fire protection systems. More frequent inspection, testing and maintenance may be necessary depending on the conditions of the occupancy and the water supply.

Owner: _____________________________________________________________________________________ WO#: ____________________________ Report#: _______________________________

Owner’s Address: _________________________________________________________________________ Owner's Phone Number: _____________________________________________________ �

Property Being Evaluated: __________________________________________________________________________________________________________________________________________________

Property Address: ___________________________________________________________________________________________________ Time Of Inspection:_________________________________

Date of Work: ____________________________________ All � responses� refer � to � the � current �work (inspection, � testing � and �maintenance) � performed � on � this � date.

This work is (check one): Weekly Monthly Quarterly Semiannual Annual Fifth Year

Part I – Owners Section

Yes� � � No�

Yes� � � No� Yes� � � No� Yes� � � No� Yes� � � No� Yes� � � No� Yes� � � No� Yes� � � No� Yes� � � No�

Yes� � � No�

____________________________________� � � � _____________________________� � � � � � _______________�Owner�or�Representative� � � � � � (Print)� Signature.�

�

� � Date.�

Part II – Inspector’s Section Owner� or� Rep.� not� on� site.

A.� INSPECTIONS �1. � Daily � and �Weekly � Items �A. Control valves supervised with seals in correct (open or closed)

position? Yes No N/A B. Backflow Preventers:

1. Valves in correct (open or closed) position? Yes No N/A 2. Sealed, locked or supervised & accessible? Yes No N/A 3. Relief port on RPZ device not discharging? Yes No N/A

C. For freezer systems, is the gauge near the compressor reading the same as the gauge near the dry-‐pipe valve? Yes No N/A 2. �Monthly � Inspection �� ems � � in �� ddition �� o �� bove �� tems) �A. Control valves with locks or electrical supervision in correct (open or

closed) position? Yes No N/A B. Sprinkler wrench with spare sprinklers? Yes No N/A C. Gauges on wet-‐pipe system in good condition and showing normal water supply pressure? Yes No N/A D. Alarm Valves: Gauges show normal supply water pressure, free from physical damage, valves in correct (open or closed) position and no leakage from retarding chamber or drains? Yes No N/A 3.� Quarterly � Inspection � Items � (in � addition � to � above � items)�A. Pressure Reducing Valve: In open position, not leaking, maintaining

downstream pressure per design criteria, and in good condition with hand wheels not broken? Yes No N/A

Design criteria is not available B. Hydraulic nameplate (calculated systems) securely attached to riser and legible? Yes No N/A C. Fire Department Connection: Visible, accessible, couplings and swivels not damaged and rotate smoothly, plugs or caps in place and undamaged, gaskets in place and in good condition, identification sign(s) in place, check valve is not leaking, clapper is in place and operating properly and automatic drain valve in place and operating properly? Yes No N/A (If plugs or caps are not in place, inspect interior for obstructions.)

D. Alarm devices free from physical damage? Yes No N/A

4.� Annual � Inspection � Items �A. Proper number and type of spare sprinklers? Yes No N/A B. Visible sprinklers:1. Free of corrosion and physical damage? Yes No N/A 2. Free of obstructions to spray patterns? Yes No N/A 3. Free of foreign materials including paint? Yes No N/A 4. Liquid in all glass bulb sprinklers? Yes No N/A

C. Visible pipe: 1. In good condition/no external corrosion? Yes No N/A 2. No mechanical damage and no leaks? Yes No N/A 3. Properly aligned and no external loads? Yes No N/A

D. Visible pipe hangers and seismic braces not damaged or loose? Yes No N/A

E. Hose, hose couplings and nozzles on sprinkler system passed inspection in accordance with NFPA 1962? NIC Yes No N/A F. Adequate heat in areas with wet piping? Yes No N/A G. Has an internal inspection of the pipe been performed by removing the flushing connection and one sprinkler near the end of a branch line within the last 5 years? NIC Yes No N/A (If the answer was "No", an internal inspection is required.) 5.� Fifth � Year� Inspection � Items�A. Alarm valves and their associate strainers, filters and restriction

orifices passed internal inspection? NIC Yes No N/A B. Check valves internally inspected and all parts operate properly, move freely and are in good condition? NIC Yes No N/A

B.Testing �The following tests are to be performed at the noted intervals. Report any failures on Part III of this form.

1. � Quarterly � Tests �A. Mechanical water flow alarm devices passed tests by opening the

inspector's test connection or bypass connection with alarms actuating and flow observed? Yes No N/A B. Post indicating valves opened until spring or torsion is felt in the rod, then closed back one-‐quarter turn? Yes No N/A C. Main drain test for system downstream of backflow or pressure reducing valve:

1.� Static Residual � � Return �

2. Was flow observed? Yes No N/A 3. Are results comparable to previous test? Yes No N/A

2.� Semiannual � Test. �A. Valve supervisory switches indicate movement? Yes No N/A B. Electrical waterflow alarm devices passed tests by opening the

inspector's test connection or bypass connection with alarms actuating and flow observed? Yes No N/A

________ ________________

A. Is the building occupied? B. Has the occupancy classification and hazard of content remained The same since the last inspection?��C. Are all fire protection systems in service?��D. Has the system remained in service without modification since last inspection? E. Was the system free of actuation of devices or alarms since the last inspection?�F. Weekly logs of inspections required by NFPA 25 on file?��G. All deficiencies reported at last inspection corrected?��H. I know the location and understand the operation of all control valves.�� I. I would like to have a copy of the NFPA 25 at an extra charge of $50.00 J. Owner or Rep. requests DynaFire to release information from inspections to the Underwriters of my insurance company.

FORM ID: SPRK07

FP16481600012009 EF20000528 Florida PE 26483 NICET IV 99907 FPC15-000057

109-B Concord Drive Casselberry, Florida

Phone: 407-830-6500 www.DynaFire.com

1-Riser=6-FloorsHampton Inn-Altamonte

Altamonte Springs FL 32714

11238451

161 Douglas Ave (407) 331-0220

Hampton Inn-Altamonte

08/09/2016 10:00am EDT

Altamonte Springs FL 32714161 Douglas Ave

08/09/2016

NFPA 25 Wet Pipe Sprinkler System Report (Page 2)

3. Annual Test.A. Main drain test:1. Static Residual Return

2. Was flow observed? Yes No N/A 3. Are results comparable to previous test? Yes No N/A

B. Are all sprinklers date 1920 or later? Yes No N/A C. Fast response sprinklers 20 or more years old replaced or successfully sample tested within last 10 years? Yes No N/AD. Standard response sprinklers 50 or more years old replaced or

successfully sample tested within last 10 years? Yes No N/A E. Standard response sprinklers 75 or more years old replaced or successfully sample tested within last 5 years? Yes No N/A F. Dry-‐type sprinkler replaced or successfully sample tested within last 10 years? Yes No N/A G. Specific gravity of antifreeze correct? Yes No N/A H. All control valves operated through full range and returned to normal position? Yes No N/A I. Backflow devices passed backflow test? NIC Yes No N/A J. Backflow devices passed full flow test? NIC Yes No N/A K. Pressure reducing valves passed partial flow test?

NIC Yes No N/A 4. Test to be done every third year:Hose (more than 5 years old) connected to the system has been service tested in accordance with NFPA 1962. Water discharged and water flow alarms operated?

NIC Yes No N/A 5. Test to be done every 5th yearA. Sprinklers rated above High temperature tested? NIC Yes No N/A B. Gauges checked by calibrated gauge or replaced? Yes No N/A C. Pressure reducing valves passed full flow test? NIC Yes No N/A

C. Maintenance 1. Regular Maintenance ItemsA. If sprinklers have been replaced, were they proper replacements?

Yes No N/A Cannot Determine B. Used hose was cleaned, drained and dried before being placed back in service? Hose exposed to hazardous materials was disposed of or decontaminated in an approved manner?

Yes No N/A Cannot Determine C. Systems normally filled with fresh water were drained and refilled twice if raw water got into the system?

Yes No N/A Cannot Determine D. If any of the following were discovered, was an obstruction investigation conducted? NIC Yes No N/A

1. Defective intake screen on pump with suction from open sources. 2. Obstructive material discharged during water flow tests.3. Foreign materials found in dry-‐pipe valves, check valves or pumps.4. Foreign material in water during drain test or plugging of inspector's test

connection. 5. Plugging of pipe or sprinklers found during activation or alteration.6. Failure to flush yard piping or surrounding public mains following newinstallation or repairs.

7. Record of broken mains in the vicinity.8. Abnormally frequent false-‐tripping of dry-‐pipe valves.9. System is returned to service after an extended period out of service (greater than one year).

10. There is reason to believe the system contains sodium silicate or itsderivatives or highly corrosive fluxes in copper pipe systems.

E. If conditions were found that required flushing, was flushing of system conducted? NIC Yes No N/A

2. Annual Maintenance ItemsA. Operating stem of all OS&Y valves lubricated completely closed, and

reopened? Yes No N/A B. Sprinklers and spray nozzles protecting commercial cooking equipment and ventilating systems replaced except for bulb-‐type which show no signs of grease buildup? Yes No N/A 3. Regular Maintenance ItemsA. Alarm panel clear? Yes No N/A B. System left in service? Yes No N/A C. Is system impaired? (Impairment program put into place per NFPA-‐25 &

DynaFire Protocols.) Yes No

��

��

��

Date:_____________________________________

��_________________________________________�

�� __________________________________________________

�� ___________________________________________________�

��:�

RED GREEN

Explain reason(s) and obstruction investigation finding in Part III

________ ________ ________

08/09/2016 10:00am EDT

Kevin Mancuso

141913

Room 611 painted 155 white QR residential 1/2" pendant head at entry. Room 308 painted 155 white QR residential 1/2" pendant head at entry.

Seals=14042,14041,14040,14039,14038, 14037,14036,14035,14034,14033,14032.

Work Order #:________________

Backflow Preventor Inspection Report

Customer Name:__________________________________________________________ Phone Number:____________

Property Address:___________________________________________________________________________________

Contractor: DynaFire Inc. License Number: FP 16481600012009

Location of Assembly:__________________________________________________ Domestic:______ Irrigation:______

Type of Assembly: RPZ DC DCDA PVB Size: _________Fire Main: ______ Bypass: ___________

Manufacturer: ___________________________ Model: _________________ Serial #: _________________

Meter: ______________________ Old Serial if applicable #: ___________ New Serial if applicable#: ____________

Check

Valve # 1

Relief

Valve

Check

Valve # 2

Pressure

Vacuum Breaker

Leaked: Leaked: Air Inlet:

Opened At:__________ PSI

Did Not Open

Closed Tight: Did Not Open: Closed Tight: Check Valve:

Leaked:

Differential Pressure

Across Check Valve

____________ PSI Opened

At:__________ PSI


Across Check Valve

____________ PSI

Cleaned Only: Cleaned Only: Cleaned Only: Cleaned Only:

Replaced: Replaced: Replaced: Replaced:

Rubber Kit Rubber Kit Rubber Kit Rubber Kit

Check Valve Assembly Check Valve

Assembly

Check Valve

Assembly

Check Valve

Assembly

Disc Disc Disc Disc

O-Rings O-Rings O-Rings O-Rings

Seat Seat Seat Seat

Spring Spring Spring Spring

Stem/Guide Stem/Guide Stem/Guide Stem/Guide

Retainer Retainer Retainer Retainer

Lock Nuts Lock Nuts Lock Nuts Lock Nuts

Other:_______________ Other:______________ Other:____________________ Other:______________________

Note: All Repairs shall be completed within thirty (30) days. Device Pass Device Fail

Remarks: _______________________________________________________________________________________________

I state that the information on this form is correct and reflects the proper operation and maintenance of the assembly.

Tester: _____________________ Certification # ________________________________ Date: __________________________

Gauge # _________________________ Date of Last Calibration: ____________________________________________

FORM ID: SPRK01




11238451

Hampton Inn-Altamonte (407) 331-0220161 Douglas Ave

In front by road

✔ 6 X

Watts 757 MJ-3567

✔ ✔

3.0 4.2

✔

Kevin Mancuso A09-15-10029 8-9-16

10151822 11/18/2015

Add New Page


Work Order #:________________









Check

Valve # 1

Relief

Valve

Check

Valve # 2

Pressure

Vacuum Breaker



Did Not Open


Leaked:


Across Check Valve

____________ PSI Opened

At:__________ PSI


Across Check Valve

____________ PSI





Assembly

Check Valve

Assembly

Check Valve

Assembly

Disc Disc Disc Disc


Seat Seat Seat Seat







Remarks: _______________________________________________________________________________________________




FORM ID: SPRK01




11238451


In front by road

✔ 3/4" XWatts 007M3 205932

✔ ✔

3.2 2.2

✔

Kevin Mancuso A09-15-10029 8-9-16

10151822 11/18/2015

Add New Page


Work Order #:________________









Check

Valve # 1

Relief

Valve

Check

Valve # 2

Pressure

Vacuum Breaker



Did Not Open


Leaked:


Across Check Valve

____________ PSI Opened

At:__________ PSI


Across Check Valve

____________ PSI





Assembly

Check Valve

Assembly

Check Valve

Assembly

Disc Disc Disc Disc


Seat Seat Seat Seat







Remarks: _______________________________________________________________________________________________




FORM ID: SPRK01




11238451


Up front by road X✔ 4"

Watts 957 NC-1322

✔ ✔

12.22.6

3.0

✔

Kevin Mancuso A09-15-10029 8-9-16

10151822 11/18/2015

Add New Page


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NFPA-25 INSPECTION, TESTING AND …€¦ · nfpa-25 inspection, testing and maintenance of wet pipe fire sprinkler system ... nfpa 1962? yes nicno n/a